2025 Measurement Effort
The Health Care Payment Learning & Action Network (HCPLAN) initially led the national Alternative Payment Model (APM) Measurement Effort (“Measurement Effort” or “survey”), starting in 2016, to evaluate adoption of APMs across lines of business, assess general market trends and track the pace of progress toward APM adoption across commercial health plans, state Medicaid agencies, Medicaid managed care organizations, Medicare Advantage plans, and Original Medicare. Under the HCPLAN’s leadership, the Centers for Medicare & Medicaid Services (CMS), AHIP, and the Blue Cross Blue Shield Association (BCBSA) served as survey partners. Beginning in 2025, AHIP assumed leadership of this work, continuing the partnership with CMS and BCBSA. This transition maintained the same measurement framework, data integrity, and partner collaboration established under the HCPLAN, reflecting a seamless shift from federal to industry stewardship and a shared commitment to tracking progress toward value-based care. For the full 2025 Measurement Effort results, review the 2025 Methodology and Results Report.
In 2024, across all lines of business (LOBs), 44.9% of U.S. health care payments flowed through an APM contract (Categories 3-4) and 28.7% flowed through a downside risk APM contract.
Percentage of U.S. Health Care Payments in Categories 3-4 and Categories 3B-4 by LOB
CY 2024 Data Year
Detailed Breakdown of Health Care Payments
Review the full results of how CY 2024 health care payments in all LOBs combined break down into each of the categories and subcategories of the HCPLAN APM Framework.
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Trends Over Time
Spending in Categories 3-4 by Year and by LOB
Data Years 2015-2024
The line graph below shows how APM spending in Categories 3 and 4 changed year over year by LOB.
The bar graph below illustrates progress in the adoption of downside risk APM spending (Categories 3B-4) by LOB since 2019.
Spending in Categories 3B-4 by Year and by LOB
Data Years 2019-2024
PAYERS’ PERSPECTIVE
All Lines of Business Payment Breakdown
Download accessible PDF of 2025 APM Measurement Report
Commercial Payment Breakdown
Download accessible PDF of 2025 APM Measurement Report
Medicare Advantage Payment Breakdown
Download accessible PDF of 2025 APM Measurement Report
Medicaid Payment Breakdown
Download accessible PDF of 2025 APM Measurement Report
Original Medicare Payment Breakdown
Download accessible PDF of 2025 APM Measurement Report
All Lines of Business Payment Breakdown
Download accessible PDF of 2025 APM Measurement Report
APM Subcategories Survey Results
Download accessible PDF of 2025 APM Measurement Report
APM Adoption Predictions
Download accessible PDF of 2025 APM Measurement Report
Download the infographic
Since its inception in 2015, the HCPLAN has measured the proportion of U.S. health care payments that flows through APMs. Over time, the HCPLAN has refined its measurement process to examine APM adoption by LOB and payments by subcategory within the four categories of the HCPLAN APM Framework. AHIP has continued the trend analyses as previously reported through the HCPLAN.